Objective To investigate the key points of nursing during the course of breast tumor excision by endoscope. Method Summarized the nursing points of 24 patients who have accepted the breast tumor excision by endoscope. Results The key points of successful operation were sufficient preparation before the operation, the special skills of nurses, exactly and quickly transfer instruments and expert cooperation. Conclusion Paving attention on psychological nursing, the correct and skillful nursing care can reduce the operation time, and then make sure the successful operation.

Chronic constipation(CC)is one of the most common gastrointestinal disorders. Treatment of CC includes drug and non-drug treatment. Biofeedback(BF)is a psychological behavior therapy and has become the first-line therapy of CC. However,the efficacy of BF reported varied substantially. This article reviewed the evaluation of efficacy of BF on CC.

Objective To investigate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of pulmonary cryptococcosis.Methods 15 patients who were diagnosed as pulmonary cryptococcosis were retrospectively studied,all of them were examined by sputum smear,X ray,CT and EBUS-TBNA.Results 15 patients who received EBUS-TBNA were diagnosed pulmonary cryptococcosis by pathological methods and germiculture,during the process no complication was detected.Conclusion EBUS-TBNA is a safe and effective means in the diagnosis of pulmonary cryptococcosis for pulmonary cryptococcosis patients hard to be diagnosed clinically.

Fetal hydrocephalus is a kind of congenital malformation,which is characterized by the enlargement of the ventricular system and the obstruction of cerebrospinal fluid.It is not accompanied by a primary brain atrophy,with or without the increase of head circumference.Early diagnosis and early treatment is very important.Without the timely inter-vention,most of the patients will die during the perinatal and infant period,and even the survivors often suffer from cere-bral palsy and mental retardation.However,the long -term prognosis and clinical course of patients with hydrocephalus is not yet fully understood.There is controversy on the factors which influence the long -term outcome,such as the timing of diagnosis of hydrocephalus,the severity of ventricular dilatation,the basic disease and accompanying anomalies.So,should establish comprehensive protocols to avoid and decrease fetal hydrocephalus,as well as pay attention to the clinicopatho-logical research,prenatal diagnosis,perinatal management and early treatment of fetal hydrocephalus.

Objective To compare clinical value of peripheral blood collection and venous blood collection methods in blood tests.Methods 467 patients who received blood test were selected.The venous blood and peripher-al blood were collected,the indicators of blood test were detected,and the test results were analyzed.Results The white blood cell count (WBC),red blood cell count (RBC),platelet count (PLT),red blood cell hematocrit (HCT),hemoglobin (HB)of venous blood were (5.7 ±1.2)×109 /L,(3.72 ±0.48)×109 /L,(218.0 ±57.5)× 109 /L,(41.8 ±19.8)g/L,(115.7 ±13.8)g/L respectively,those of peripheral blood were (6.7 ±3.4)×109 /L, (3.62 ±0.72)×109 /L,(204.0 ±87.7)×109 /L,(32.7 ±20.7)g/L,(103.6 ±19.6),the differences were statis-tically significant (t =5.994,2.497,2.885,6.865,10.908,all P <0.05).The mean red cell hemoglobin concentra-tion (MCHC),mean red cell volume (MCV),mean erythrocyte hemoglobin (MCH)and other indexes had no signifi-cant differences(all P >0.05).Conclusion The test results in patients with venous and peripheral blood was quite different,venous blood test results obtained with greater value in clinical use,it is recommended that routine blood test used venous blood.

Objective To discuss the reasonable utilization of β-lactam antibiotics in patients with renal failure on hemedialysis. Methods The clinical characteristics of patients with renal failure on hemodylysis,who de-veloped the adverse effect of nervous system and psychiatric symptom while being treated with β-lactam antibiotics,were retrospectively analyzed. Results The adverse effect of nervous system and psychiatric symptom showed dur-ing and after hemodialysis,including: mental confusion,hyperexcitabiliy,incoherent speech,lethargy and amyestasia in two cases. Physical examination did not show signs of cerebral focal injury in all cases. Computed tomography of brain in 7 patients did not show acute lesions. The symptoms completely disappeared after withdrawal of β-lactam antibiotics but bemodialysis or hemodiafiltration continued. Conclusion β-lactam antibiotics used in conventional dose could cause temporary adverse effect of nervous system in patients with renal failure on bemodialysis,which is related to prolongation of drug half life.

SALL4 gene is closely related to body malformations related diseases, embryonic stem cell development, and hematopoietic malignancies. SALL4 can activate hematopoietic stem cell through Wnt signaling pathways, and promote continued proliferation of leukemia stem cells, leading to leukemia. In-depth study of SALL4 gene and its protein function will help clarify the pathogenesis of leukemia, providing a new target for the treatment of leukemia.

OBJECTIVE To measure the dexamethasone concentration in the cochlear tissue after postaurical and intramuscular administration. METHODS After bilateral adrenalectomy,animals were divided into three groups:postaurical injection group,intramuscular injection group,and physiological saline injected blank control group.At 0.25,0.5, 2.5,5,12,24,72 h after injection(1mg/100g), cochleae together with the intact endolymphatic sac were removed and homogenated.After that, the dexamethasone was detected by enzymelinked immunosorbent assay(ELISA).RESULTS The dexamethasone levels in the cochlear tissue in postaurical injection group were significantly higher than that in the intramuscular injection group.In the postaurical administration group,a mean peak cochlear tissue concentration of(175.2?36.0) ng/ml was detected at 0.25 h after injection,then declined obviously 12 h and was below detection limits by 24h.While in the intramuscular administration group, a mean peak concentration was observed 2.5 h at the concentration of(141.1?8.9) ng/ml,then rapidly declined from 5h and beyond detection by 24 h.CONCLUSION Compared with intramuscular administration,the dexamethasone levels in the postaurical injection group were significantly higher, with peak concentration reached earlier,and last longer.

Objective To screen the influencing factors related to prolonged mechanical ventilation (PMV). Methods Series of parameters of 154 elderly patients with pneumonia or COPD exacerbation were collected before using ventilator, after weaning of ventilator or at the 21st day of ventilating, respectively. Results By single factor analysis, PMV related to not only age, lying on bed, white blood cell, neutrophil, P (A-a)O 2, BUN, Cr, upper digestive tract bleeding, heart rate(HR), and blood pressure(BP) before using ventilator, but also related to heart function and consciousness after ventilator weaning or ventilating for 21 days. By multiple factor analysis, age, P (A-a) O 2 , heart function when ventilating for 21 days were related to PMV. Age≥82.0, P (A-a)O 2 ≥95.0 mm Hg, heart function≥grade 3 were high risk factors of PMV. Furthermore, it was found that the accuracy rate for meeting with those three parameters among 8 elderly patients with PMV was 87.5%. Conclusions Age, P (A-a)O 2 and heart function when ventilating for 21 days might be the independent factors of PMV.

Objective To explore the effects of micro channel (mPCNL)and standard channel percutaneous lithotripsy (sPCNL)on hemodynamics and blood gas analysis in patients with renal calculi.Methods From March 2007 to June 2015,180 patients with kidney stones were selected as the research subjects,through digital said method,the patients were randomly divided into MPCNL group and sPCNL group,the former F16 plastics through established channels of percutaneous nephrolithotomy.The latter F24 plastics through established channels of percuta-neous nephrolithotomy.The changes of hemodynamics and blood gas analysis were observed and compared in the two groups during perioperative period .Results In MPCNL group ,theoperation time was significantly shorter in sPCNL group(t =-6.018),the perfusion fluid was higher than that of sPCNL group(t =20.506,P <0.05).The perfusion of MAP and CVP of the two groups were significantly lower than those before anesthesia,and irrigation flow after dif-ferent time and postoperative were significantly higher than those before hemoperfusion,60 min,120min,after opera-tion MAP value of MPCNL group,test value was as follows(t60min =5.878,t120min =6.802,tpostoperative =7.070,all P <0.05);60min,120min,after operation CVP value of MPCNL group,test value was as follows (t60min =5.987,t120min =6.505,tpostoperative =7.180,all P <0.05).60min,120min,postoperative MAP value of sPCNL group,test value was as follows (t60min =5.613,t120min =7.238,tpostoperative =7.170,all P <0.05);60min,120min,postoperative the CVP value of sPCNL group,test value was as follows (t60min =7.682,t120min =7.135,t[postoperative]=9.218,all P <0.05). Blood gas analysis showed that the two groups of postoperative Na +,Cl - compared with before anesthesia had no sta-tistically significant difference(P >0.05).Two groups of postoperative K +,pH,BE,Hb were lower than before anes-thesia,the differences were statistically significant (P <0.05).The two groups of patients with no postoperative urina-ry sepsis and other serious complications.Conclusion With the increase of operation time filling fluid absorption on hemodynamics and arterial blood gas analysis of influence gradually increased;in heart,lung and normal renal function patients,due to the compensatory organ function,caused by MPCNL and sPCNL irrigation fluid absorption differences in the amount is not enough to cause different hemodynamics and blood gas analysis.